3rd Year Modules: Autism

Unlike modules for first and second years, final year undergraduate modules in the School of Psychology at UNMC are entirely developed by lecturers at the campus. Each of us has the chance to develop a module from scratch on an area of our choosing – usually our own particular research specialism – and I think it’s fair to say that this is when students get to see lecturers in their element. The module I’ve developed focuses on the neurodevelopmental condition, autism spectrum disorder (ASD). Students in psychology come to this module having already covered some classic theories of autism in their second year of study so the module aims to provide a much more contemporary perspective on the condition, informed by the most recent developments in the field.

This means the module is very much still a work in progress and requires constant updating. This year, I’ve had to adapt to the publication of the newest edition of the Diagnostic and Statistical Manual of mental disorders (DSM-5) which was released in May. Published by the American Psychiatric Association, this handbook essentially lists the criteria for all mental health conditions based on the discipline’s most up-to-date understanding of their nature. What students might be surprised to learn is just how major the changes can be to the way in which psychological disorders are defined. In relation to ASD, DSM-5 does away with the various subtypes of the condition (such as autism, Asperger Syndrome) in favour of the single term ‘autism spectrum disorder’ – the decision to do so based on the view that research does not consistently support there being a distinction between these diagnostic categories. The eradication of autism and Asperger Syndrome as distinct conditions has provoked extensive debate within both academic and practitioner communities, and I hope students will get a sense of some of the associated drama. I’ll be recommending blogs of respected ASD researchers and newspaper articles as well as journal articles for reading. Come to think of it, I may also need to change the name of the module…

Another update I’ve made to the module for 2013/14 is to include a lecture on cross-cultural issues in relation to ASD, coinciding with the forthcoming publication of a chapter written by Megan Freeth, Rajani Ramachandran, Liz Milne and myself on this same topic for the Handbook of Autism and Pervasive Developmental Disorders (4th Edition). The potential impact of culture on ASD has become a hot topic over the last few years, part of a more general growing concern that psychological research has been overwhelmingly Western-centric, as an increasing number of studies suggest that many aspects of human cognition and behaviour previously assumed to be universal are actually subject to cultural differences. ASD is diagnosed primarily based on abnormalities in social behaviour; in other words, in order to receive a diagnosis, an individual’s behaviour must deviate from whatever is normal. Yet differing cultural/societal norms exist for a variety of social behaviours. For instance, having ‘unusual eye contact’ is regarded as indicative of an ASD, but there are also widely documented cross-cultural differences in the extent to which maintaining eye contact is regarded as acceptable or polite.

How differing cultural norms in relation to behaviour impact on the way in which ASD is expressed is unknown as the research simply hasn’t been done yet. There are some pretty hefty implications though, for both diagnosis and treatment. The use of diagnostic tools developed in Western cultures could lead to either over- or under-diagnosis of ASD in non-Western cultures – hence, culture-specific assessment and intervention procedures may be required. These kinds of issues, which arise not just in relation to autism but to a variety of psychological conditions, represent a huge challenge for researchers and practitioners in non-western cultures – but also a big opportunity for our students as the next generation of clinical psychologists and researchers. I’d like to think that some of them will go forward and start to address this gap in our understanding of ASD and other conditions.

Dr. Lizzy Sheppard(Associate Professor& Head of School of Psychology, UNMC)